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Radiosynovectomy: Introduction and Overview of the Literature

  • Chapter
Local Treatment of Inflammatory Joint Diseases

Abstract

Chronic synovitis is the most common reason for damage to the joints.

Among the different possibilities for the local treatment of synovitis, the intraarticular injection of radionuclides, called radiosynovectomy, radiosynoviorthesis or just RSO, is performed to treat the synovial inflammation alternatively to surgery.

According to the literature a various list of indications for RSO is reported. The clinical outcome differs and depends on the primary disease, the type of the affected joints and the pre-existing degenerative changes.

In an analysis of the literature, it could be demonstrated that RSO was appropriate with a high clinical response rate (>80 %) in association with pain relief, decrease of synovitis and/or increasing mobility in the early stage of rheumatoid arthritis (RA) with moderate synovial swelling and without changes on radiography. Similar response rates were found with haemarthrosis in case of haemophilia and pigmented villonodular synovitis without pre-existing morphological changes.

An acceptable clinical improvement with a response rate of 60–80 % was found in rheumatoid arthritis (RA) and osteoarthritis (OA) with minimal or moderate abnormalities of the joints. RSO was also helpful with a clinical response rate <60 % in case of severe pre-existing morphological changes.

RSO was highly effective in large- as well as medium-sized joints. Interestingly, the clinical response rate of the upper extremity seemed to be higher than that for the lower extremity joints. RSO was also highly effective in synovitis of the finger joints. The best results could be achieved in the thumb base joints.

In clinical routine the co-injection of corticosteroids with radiopharmaceuticals was most often used, as this combination therapy showed more favourable results than corticosteroids alone.

In summary, RSO provides among the different treatment methods for joint inflammation an effective alternative therapy to surgical synovectomy. However, a close cooperation with the rheumatologists and orthopaedists is necessary to consider RSO in each patient to ensure optimal medical care.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Private Hospital, Dr. Walter Hochsteiner Strasse 4, Villach, 9504, Austria

    Ewald Kresnik

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  1. Ewald Kresnik
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Correspondence to Ewald Kresnik .

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Editors and Affiliations

  1. Nuklearmedizin Spitalerhof, Hamburg, Germany

    Willm Uwe Kampen

  2. Kassel, Germany

    Manfred Fischer

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Kresnik, E. (2015). Radiosynovectomy: Introduction and Overview of the Literature. In: Kampen, W., Fischer, M. (eds) Local Treatment of Inflammatory Joint Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-16949-1_6

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  • DOI: https://doi.org/10.1007/978-3-319-16949-1_6

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-16948-4

  • Online ISBN: 978-3-319-16949-1

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